Background: The coronavirus pandemic had a major impact in Italy. The Italian health system’s re-... more Background: The coronavirus pandemic had a major impact in Italy. The Italian health system’s re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers. Methods: All patients assessed for gastric adenocarcinoma at nine GIRCG centers between January 2019 and November 2020 were included. Patients were grouped according to the date of “patient 1’s” diagnosis in Italy: preCOVID versus COVID. Clinico-pathological and outcome differences between the two groups were analyzed. Results: A total of 632 patients were included in the analysis (205 in the COVID group). The cT4 weighted ratios were higher in 2020 from April to September, with the greatest differences in May, August and September. The cM+ weighted ratio was significantly higher in July 20...
Introduzione: Il sarcoma fibromixoide a basso grado (LGFMS) e una rara neoplasia che di solito co... more Introduzione: Il sarcoma fibromixoide a basso grado (LGFMS) e una rara neoplasia che di solito colpisce giovani adulti ma riportata anche in bambini e di solito a partenza dai tessuti molli delle estremita prossimali. Riportiamo un caso di LGFMS con eccezionale localizzazione retroperitoneale e sconfinante all’inguine. Caso clinico: Un uomo di 40 anni dopo una storia di dolori addominali ingravescenti e sintomi sub-occlusivi, veniva sottoposto prima ad ecografia addominale e poi a TC con mdc per una massa retroperitoneale di 11x10x10 cm adesa al muscolo ileo-psoas dx che dislocava medialmente anse ileali,cieco e vescica. Per l’aggravamento rapido della sintomatologia e stato sottoposto direttamente a chirurgia senza previa biopsia. Si e proceduto ad exeresi radicale previa biopsia intraoperatoria (sarcoma a basso grado) della massa, che dislocava senza comprimere i vasi spermatici ed iliaci, e che sconfinava con una propaggine di 4 cm in regione inguinale attraverso la lacuna vasoru...
We read, with great interest, the article by Huang Ruo-Yi and colleagues entitled “Outcomes of Co... more We read, with great interest, the article by Huang Ruo-Yi and colleagues entitled “Outcomes of Conversion Surgery for Metastatic Gastric Cancer Compared with In-Front Surgery Plus Palliative Chemotherapy or In-Front Surgery Alone”, published on 1 April 2022 [...]
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Robotic surgery is becoming more and more frequent. In colon surgery it can be used safely with s... more Robotic surgery is becoming more and more frequent. In colon surgery it can be used safely with similar results to laparoscopic surgery. The objective of our work is to retrospectively compare the short-term results (30 days) of robotic and laparoscopic right hemicolectomy. It will be helpful to understand if there are any advantages of robotic over laparoscopic surgery. Methods: Data of miniinvasive (laparoscopic and robotic) right colectomy procedures performed from January 1, 2013 to December 31, 2019 in two Tuscany hospitals were retrospectively collected and analyzed. The mean hospital stay, complication rate, flatus pass, operative time, conversion rate and the number of removed lymph nodes, between the two methods have been compared. Results: The total number of the patients that underwent right miniinvasive colectomy was 211. Sixteen patients were excluded from the study. Of the 195 included patients, 143 were operated with the robotic approach, and 52 with the laparoscopic one. There was no significant difference between the mean hospital stay (7 days in both), canalization to gas (4 days in both), anastomotic dehiscence (2 in robotic and 1 in laparoscopy), and Clavien Dindo 3 - 5 grade complications. The operation time (215 vs 175 min) and the number of retrieved lymph nodes (19 vs 15) were significantly greater in the robotic approach. Conclusion: The robotic approach may be advantageous in terms of surgical radicality with the price of a greater operative time. Key words: Laparoscopic, Right colectomy, Robotic.
Background The present study provides a snapshot of Italian patients with peritoneal metastasis f... more Background The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery. Methods It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences. Results Our results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could ...
I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all... more Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all extranodal GI tract lymphomas. The majority of PGLs are B cell non-Hodgkin's lymphomas or a high grade, diffuse, large cell lymphoma. The development of gastric mucosa associated lymphoid tissue is dependent on Helicobacter pylori infection. From January 2000 to February 2004, 10 patients were observed in the Unit of Surgical Oncology at Morgagni-Pierantoni Hospital in Forlì (6 F, 4 M), mean age was 68.3 (range, 45-86). Diagnosis was made in all patients by endoscopy and biopsies of gastric mucosa, US endoscopy and TC-PET. According to the Ann-Arbor classification modified by Musshoff, 6 patients were stage IE(1), 1 IE(2), 1 IIIE. 2 IV. Four and two patients underwent distal or total gastrectomy. respectively. Chemotherapy was performed in three patients, RT in one patient. Complete remission was observed in patients submitted to surgery and chemotherapy alone. No mortality and morb...
Peritoneal carcinomatosis is the first cause of death after surgery for abdominal cancer, with a ... more Peritoneal carcinomatosis is the first cause of death after surgery for abdominal cancer, with a mean survival of 7 months. In selected patients, aggressive cytoreductive therapy combined with hyperthermic intraperitoneal chemotherapy my improve medium to long-term survival. Over the period from 2004 to January 2006, 86 patients were operated on for peritoneal carcinomatosis at the Division of Surgical Oncology, Forli, Italy. Thirteen of them were submitted to hyperthermic chemotherapy. The authors present their preliminary experience with the treatment of colorectal carcinosis by 30-min hyperthermic (41.5-42 degrees C intraperitoneal perfusion with oxaliplatin (400 mg/sq.m.) and intravenous 5-FU (400 mg/sq.m.) after complete cytoreductive surgery. The average surgical time was 606 min (range: 380-765). No intraoperative complications occurred, but 4 cases of major postoperative morbidity were reported, one of which requiring surgery. One patient died 5 months postoperatively due to...
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Written radiological report remains the most important means of communication between radiologist... more Written radiological report remains the most important means of communication between radiologist and referring medical/surgical doctor, even though CT reports are frequently just descriptive, unclear, and unstructured. The Italian Society of Medical and Interventional Radiology (SIRM) and the Italian Research Group for Gastric Cancer (GIRCG) promoted a critical shared discussion between 10 skilled radiologists and 10 surgical oncologists, by means of multi-round consensus-building Delphi survey, to develop a structured reporting template for CT of GC patients. Twenty-four items were organized according to the broad categories of a structured report as suggested by the European Society of Radiology (clinical referral, technique, findings, conclusion, and advice) and grouped into three “CT report sections” depending on the diagnostic phase of the radiological assessment for the oncologic patient (staging, restaging, and follow-up). In the final round, 23 out of 24 items obtained agre...
Background: The coronavirus pandemic had a major impact in Italy. The Italian health system’s re-... more Background: The coronavirus pandemic had a major impact in Italy. The Italian health system’s re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers. Methods: All patients assessed for gastric adenocarcinoma at nine GIRCG centers between January 2019 and November 2020 were included. Patients were grouped according to the date of “patient 1’s” diagnosis in Italy: preCOVID versus COVID. Clinico-pathological and outcome differences between the two groups were analyzed. Results: A total of 632 patients were included in the analysis (205 in the COVID group). The cT4 weighted ratios were higher in 2020 from April to September, with the greatest differences in May, August and September. The cM+ weighted ratio was significantly higher in July 20...
Introduzione: Il sarcoma fibromixoide a basso grado (LGFMS) e una rara neoplasia che di solito co... more Introduzione: Il sarcoma fibromixoide a basso grado (LGFMS) e una rara neoplasia che di solito colpisce giovani adulti ma riportata anche in bambini e di solito a partenza dai tessuti molli delle estremita prossimali. Riportiamo un caso di LGFMS con eccezionale localizzazione retroperitoneale e sconfinante all’inguine. Caso clinico: Un uomo di 40 anni dopo una storia di dolori addominali ingravescenti e sintomi sub-occlusivi, veniva sottoposto prima ad ecografia addominale e poi a TC con mdc per una massa retroperitoneale di 11x10x10 cm adesa al muscolo ileo-psoas dx che dislocava medialmente anse ileali,cieco e vescica. Per l’aggravamento rapido della sintomatologia e stato sottoposto direttamente a chirurgia senza previa biopsia. Si e proceduto ad exeresi radicale previa biopsia intraoperatoria (sarcoma a basso grado) della massa, che dislocava senza comprimere i vasi spermatici ed iliaci, e che sconfinava con una propaggine di 4 cm in regione inguinale attraverso la lacuna vasoru...
We read, with great interest, the article by Huang Ruo-Yi and colleagues entitled “Outcomes of Co... more We read, with great interest, the article by Huang Ruo-Yi and colleagues entitled “Outcomes of Conversion Surgery for Metastatic Gastric Cancer Compared with In-Front Surgery Plus Palliative Chemotherapy or In-Front Surgery Alone”, published on 1 April 2022 [...]
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Robotic surgery is becoming more and more frequent. In colon surgery it can be used safely with s... more Robotic surgery is becoming more and more frequent. In colon surgery it can be used safely with similar results to laparoscopic surgery. The objective of our work is to retrospectively compare the short-term results (30 days) of robotic and laparoscopic right hemicolectomy. It will be helpful to understand if there are any advantages of robotic over laparoscopic surgery. Methods: Data of miniinvasive (laparoscopic and robotic) right colectomy procedures performed from January 1, 2013 to December 31, 2019 in two Tuscany hospitals were retrospectively collected and analyzed. The mean hospital stay, complication rate, flatus pass, operative time, conversion rate and the number of removed lymph nodes, between the two methods have been compared. Results: The total number of the patients that underwent right miniinvasive colectomy was 211. Sixteen patients were excluded from the study. Of the 195 included patients, 143 were operated with the robotic approach, and 52 with the laparoscopic one. There was no significant difference between the mean hospital stay (7 days in both), canalization to gas (4 days in both), anastomotic dehiscence (2 in robotic and 1 in laparoscopy), and Clavien Dindo 3 - 5 grade complications. The operation time (215 vs 175 min) and the number of retrieved lymph nodes (19 vs 15) were significantly greater in the robotic approach. Conclusion: The robotic approach may be advantageous in terms of surgical radicality with the price of a greater operative time. Key words: Laparoscopic, Right colectomy, Robotic.
Background The present study provides a snapshot of Italian patients with peritoneal metastasis f... more Background The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery. Methods It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences. Results Our results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could ...
I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all... more Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all extranodal GI tract lymphomas. The majority of PGLs are B cell non-Hodgkin's lymphomas or a high grade, diffuse, large cell lymphoma. The development of gastric mucosa associated lymphoid tissue is dependent on Helicobacter pylori infection. From January 2000 to February 2004, 10 patients were observed in the Unit of Surgical Oncology at Morgagni-Pierantoni Hospital in Forlì (6 F, 4 M), mean age was 68.3 (range, 45-86). Diagnosis was made in all patients by endoscopy and biopsies of gastric mucosa, US endoscopy and TC-PET. According to the Ann-Arbor classification modified by Musshoff, 6 patients were stage IE(1), 1 IE(2), 1 IIIE. 2 IV. Four and two patients underwent distal or total gastrectomy. respectively. Chemotherapy was performed in three patients, RT in one patient. Complete remission was observed in patients submitted to surgery and chemotherapy alone. No mortality and morb...
Peritoneal carcinomatosis is the first cause of death after surgery for abdominal cancer, with a ... more Peritoneal carcinomatosis is the first cause of death after surgery for abdominal cancer, with a mean survival of 7 months. In selected patients, aggressive cytoreductive therapy combined with hyperthermic intraperitoneal chemotherapy my improve medium to long-term survival. Over the period from 2004 to January 2006, 86 patients were operated on for peritoneal carcinomatosis at the Division of Surgical Oncology, Forli, Italy. Thirteen of them were submitted to hyperthermic chemotherapy. The authors present their preliminary experience with the treatment of colorectal carcinosis by 30-min hyperthermic (41.5-42 degrees C intraperitoneal perfusion with oxaliplatin (400 mg/sq.m.) and intravenous 5-FU (400 mg/sq.m.) after complete cytoreductive surgery. The average surgical time was 606 min (range: 380-765). No intraoperative complications occurred, but 4 cases of major postoperative morbidity were reported, one of which requiring surgery. One patient died 5 months postoperatively due to...
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
Written radiological report remains the most important means of communication between radiologist... more Written radiological report remains the most important means of communication between radiologist and referring medical/surgical doctor, even though CT reports are frequently just descriptive, unclear, and unstructured. The Italian Society of Medical and Interventional Radiology (SIRM) and the Italian Research Group for Gastric Cancer (GIRCG) promoted a critical shared discussion between 10 skilled radiologists and 10 surgical oncologists, by means of multi-round consensus-building Delphi survey, to develop a structured reporting template for CT of GC patients. Twenty-four items were organized according to the broad categories of a structured report as suggested by the European Society of Radiology (clinical referral, technique, findings, conclusion, and advice) and grouped into three “CT report sections” depending on the diagnostic phase of the radiological assessment for the oncologic patient (staging, restaging, and follow-up). In the final round, 23 out of 24 items obtained agre...
Uploads
Papers